Alprazolam vs. Diazepam

Medically Reviewed on 9/14/2022

Alprazolam vs. diazepam quick comparison

What is alprazolam? What is diazepam? What are they used for?

Alprazolam (Xanax XR, Niravam) is an anti-anxiety medication in the benzodiazepine family. It is used to treat anxiety disorders and panic attacks. Alprazolam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits activity in the brain. It is believed that excessive activity in the brain may cause anxiety or other psychiatric disorders.

Diazepam (Valium) is an oral benzodiazepine medication used to treat anxiety. Diazepamt also is used to treat agitation, tremors, delirium, seizures, and hallucinations resulting from alcohol withdrawal.

Alprazolam (Xanax) uses

  • Alprazolam (Xanax) is used for the treatment of anxiety disorders and panic attacks

Diazepam uses

  • Diazepam is used for the treatment of disorders with anxiety.
  • Diazepam also is used for the treatment of agitation, tremors, delirium, seizures, and hallucinations resulting from alcohol withdrawal.
  • It is used for the treatment of seizures, relief of muscle spasms in some neurological diseases, and for sedation during surgery.


A Visual Guide to Generalized Anxiety Disorder See Slideshow

What are the side effects of alprazolam vs. diazepam?

Alprazolam side effects

Alprazolam is used for the treatment of anxiety disorders and panic attacks. Anxiety disorders are characterized by:

Panic attacks occur either unexpectedly or in certain situations (for example, driving), and can require higher dosages of alprazolam.

Diazepam side effects

The most common side effects of diazepam are:

Other important side effects include:

Possible serious side effects:

Are alprazolam and diazepam addictive?

Both alprazolam and diazepam can lead to addiction (dependency), especially when higher dosages are used over prolonged periods of time. In patients addicted to diazepam or after prolonged use, abrupt discontinuation may cause symptoms of withdrawal such as:

  • Insomnia
  • Headaches
  • Nausea
  • Vomiting
  • Lightheadedness
  • Sweating
  • Anxiety
  • Fatigue
  • Seizures can occur in more severe cases of withdrawal. Therefore, after extended use, diazepam should be slowly tapered under a doctor's supervision rather than abruptly stopped.


Panic attacks are repeated attacks of fear that can last for several minutes. See Answer

What is the dosage for alprazolam vs. diazpam?

Alprazolam dosage

  • The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily.
  • The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily.
  • The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily.
  • Alprazolam may be taken with or without food.

Diazepam dosage

  • Diazepam may be taken with or without food.
  • Diazepam is disposed of by the liver and excreted mainly by the kidney. Dosages of diazepam may need to be lowered in patients with abnormal kidney function.
  • The usual oral diazepam dose for anxiety or seizures is 2-10 mg given 2-4 times daily.
  • The usual rectal dose is 0.2-0.5 mg/kg and depends on the age of the patient.

Subscribe to MedicineNet's Depression Newsletter

By clicking "Submit," I agree to the MedicineNet Terms and Conditions and Privacy Policy. I also agree to receive emails from MedicineNet and I understand that I may opt out of MedicineNet subscriptions at any time.

What drugs interact with alprazolam vs. diazepam?

Alprazolam drug interactions

Diazepam drug interactions

Alcohol or medications that cause sedation may add to the sedative effects of diazepam. Patients taking benzodiazepines should avoid such combinations.

The following drugs may prolong the effects of diazepam by inhibiting liver enzymes that eliminate diazepam so dosages may need to be decreased when these drugs are used with diazepam.

Carbamazepine (Tegretol), rifampin (Rifadin), and St. John's Wort decrease levels of diazepam by increasing the elimination of diazepam by liver enzymes.

Are alprazolam and diazepam safe to take if I'm pregnant or breastfeeding?

  • Benzodiazepines like alprazolam and diazepam can cause fetal abnormalities and should not be used during pregnancy.
  • Both alprazolam and diazepam are excreted in breast milk, and can affect nursing infants. Therefore, diazepam should not be used by women who are nursing.


Alprazolam (Valium) and diazepam (Xanax) are medications that belong a drug class called benzodiazepines. Both alprazolam and diazepam are prescribed to treat anxiety disorders and panic attacks. Diazepam also is used to treat seizures and muscle spasms. The common side effects between alprazolam and diazepam are drowsiness and fatigue. Other side effects of alprazolam include constipation, changes in weight, addiction, and memory problems. Other side effects of diazepam include diarrhea, rash, euphoria, loss of balance, insomnia, rage, confusion, and double vision. Do not take if pregnant or breastfeeding.

Treatment & Diagnosis

Medications & Supplements

Health Solutions From Our Sponsors

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Medically Reviewed on 9/14/2022
FDA Prescribing Information